Monteggia fracture: description
Monteggia fracture: concomitant injuries
When the radial head is dislocated, the small annular ligament between the radial head and the ulna (ligamentum anulare radii) also tears. Other injuries can also occur, for example the so-called olecranon fracture. This is a fracture of the end of the ulna on the elbow side. The olecranon fracture accounts for more than one third of all cases of elbow fracture (elbow fracture).
Vessels running through the cubital fossa (a pit bounded by muscles in the area of the elbow) can be damaged in a Monteggia fracture, resulting in compartment syndrome.
If the radial nerve is injured, radial palsy results, which is manifested by paralysis of the extensor muscles of the hand and fingers (drop hand).
Galeazzi fracture
Both the Galeazzi and Monteggia fractures are each named after an Italian surgeon: Riccardo Galeazzi (1866-1952) and Giovanni Battista Monteggia (1762-1815).
Monteggia fracture: frequency
Monteggia fracture is rare but often overlooked: In five to ten percent of cases, it is not discovered or is misinterpreted as an isolated ulnar fracture (the radial head dislocation is overlooked).
Monteggia fracture: symptoms
Monteggia fracture: Causes and risk factors.
One possible cause of a Monteggia fracture is direct trauma to the edge of the ulna. In other cases, indirect trauma is behind it, for example, a fall on the outstretched arm while the forearm is rotated inward.
Monteggia fracture: examinations and diagnosis
- How exactly did the accident happen?
- Does the forearm hurt, and is its mobility limited?
- Was there any previous discomfort in the arm such as pain, limited range of motion, or a previous dislocation?
This is followed by a physical examination: the doctor examines the arm, palpating it carefully and looking for soft tissue damage, among other things. He also checks blood flow, motor function and sensitivity of the arm.
Monteggia fracture: treatment
In adults, a Monteggia fracture is always treated with surgery. First, the surgeon stabilizes the ulna by inserting a metal plate to the bone (plate osteosynthesis). This usually causes the head of the radius to reset itself. Then the surgeon sutures the torn annular ligament.
Monteggia fracture in children
If the closed reduction of the radial head is not successful, the reduction must be performed in an operation.
Monteggia fracture: course of disease and prognosis
The Monteggia fracture should be treated as an emergency: The earlier this is done, the more easily the radial head can be set. In addition, early dislocation improves the prognosis.
